Water and its importance for female body

Summary Water is an essential part of every living organism. Homeostasis in the aspect of water is necessary to retain normal function of the body. Even small dysfunction in its distribution may cause reversible and later irreversible changes in cell and organ functions. The quality and proper distribution of water is a necessary condition to maintain health at different stages of life. It is especially important in procreative period. The article presents the importance of water for the body and negative effects on health due to lack of water or its improper distribution, particularly with regard to pregnant and breastfeeding women

Wewnątrzmaciczne ograniczenie wzrastania płodu

Hipotrofia wewnątrzmaciczna (FGR, IUGR) według definicji przyjętej przez WHO jest powikłaniem ciąży polegającymna urodzeniu płodu o masie znajdującej się poniżej 10. centyla. Czynniki ryzyka wystąpienia IUGR można podzielićna matczyne, płodowe i związane z łożyskiem. Wśród nich wymienia się obecność nieprawidłowych stężeń markerówbiochemicznych — białka PAPPA, łożyskowego czynnika wzrostu — PIGF oraz rozpuszczalnego receptora VEGF— sFlt-1. Hipotrofii wewnątrzmacicznej towarzyszą również efekty odległe, takie jak: niedobór masy ciała i maływzrost, zaburzenia odporności, zaburzenia neuropsychiatryczne, zespół metaboliczny, dna moczanowa. Badanieultrasonograficzne jest najbardziej precyzyjną metodą diagnostyki IUGR. Hipotrofia wewnątrzmaciczna dzieli się napostać wczesną i późną, a według dawnej klasyfikacji na symetryczną, asymetryczną, mieszaną i konstytucjonalną.Stopień nasilenia ocenia się według uzyskanego centyla. Leczenie w większości przypadków jest mało efektywne.Postępowanie jest uzależnione od czasu trwania ciąży oraz wyników monitorowania stanu wewnątrzmacicznegopłodu. Wnioski: IUGR jest trudna do skutecznego leczenia ze względu na wieloprzyczynowość i brak jednej skutecznejmetody terapeutycznej. Nie mija w momencie urodzenia i powoduje odlegle skutki zdrowotne. Przedwczesnezakończenie ciąży jest zalecane w przypadku nieprawidłowych wyników badań monitorujących stan płodu. Koniecznejest zapobieganie hipotrofii w grupach ryzyka

Rola niedoboru witaminy D w patofizjologii zaburzeń występujących w zespole policystycznych jajników

Vitamin D deficiency, connected with insufficient production in the skin and limited alimentation delivery, disrupts the function of all systems of the body and increases the risk of chronic diseases. Many studies have reported associations between low serum 25-hydroxyvitamin D [25(OH)D] level and symptoms of the polycystic ovary syndrome (PCOS) – insulin resistance, hirsutism, and infertility associated with both, ovulatory disorders and abnormal endometrial receptivity. The beneficial effects of vitamin D supplementation on insulin resistance, ovarian follicles maturation, ovulation and menstrual regularity were confirmed. Due to limited evidence, the additional randomized trials are required to establish the correct dose of vitamin D and confirm the effectiveness of vitamin D treatment in PCOS disorders. However, it seems evident that correct supplementation of vitamin D is beneficial in the management of women with PCOS and low 25(OH)D serum levels, and that it could be helpful in improving the effects of PCOS treatment.Niedobór witaminy D, związany z niedostatecznym jej wytwarzaniem w skórze oraz ograniczonym dostarczaniem w pożywieniu, zaburza funkcje wszystkich układów organizmu oraz zwiększa ryzyko wystąpienia chorób przewlekłych. Badania sugerują związek niedoboru witaminy D3 z objawami zespołu policystycznych jajników (PCOS) - insulinoopornością, hirsutyzmem, niepłodnością związaną zarówno z zaburzeniami owulacji jak i nieprawidłową receptywnością endometrium. Stwierdzono korzystny wpływ suplementacji witaminą D na poprawę insulinowrażliwości, dojrzewanie pęcherzyków jajnikowych, występowanie owulacji oraz regulację cykli miesiączkowych. Z uwagi na ograniczoną liczbę doniesień, potwierdzenie skuteczności leczenia witaminą D zaburzeń w PCOS oraz ustalenie jej właściwej dawki wymaga przeprowadzenia badań randomizowanych. Wydaje się jednak, że wdrażanie właściwej suplementacji, szczególnie u kobiet, u których potwierdzony zostanie niedobór witaminy D jest postępowaniem korzystnym dla efektu leczenia pacjentek z PCOS

The latent infection of human papilloma virus in pregnat woman and colonization of placenta – preliminary report

Abstract Human papilloma virus infection may have a latent form without characteristic changes in Pap-smears. Some data suggests there exists a possibility of materno-foetal transmission of the HPV infection. HPV infection may be one of the possible reasons for IUGR. Aim: The main aim of the study was to find DNA HPV in the Pap-smear and placentas in pregnancy complicated by the intrauterine growth restriction. Material and methods: In two groups of women with normal Pap-smears, the material for DNA presence was taken from the uterine cervix and from the central part of placenta after the delivery. The study group consisted of pregnant women with the pregnancy complicated by fetal growth restriction. The control group consisted of women with normal fetal weight pregnancy. In cervical smears and placental fragments the presence of HPV DNA and typing of HPV using the PCR method has been done. Results: In the control group the presence of low risk types of HPV was found but DNA HPV wasn’t present in the placental fragments. In the study group, in 4 cases high risk HPV DNA was found in cervical smears and in 3 of those cases HPV DNA was also present in the placental fragments. In two cases it was type 16, in one – type 18. Conclusions: The latent form of high risk HPV infection might be the reason for materno-foetal transmission of HPV. The high rate of high oncogenic risk types of HPV in the group of pregnancies complicated by IUGR might suggest the correlation between HPV infection and IUGR etiology

Human papilloma virus infection in pregnant women with normal Pap-smears, HPV oncogenity and risk factors

The process of carcinogenesis in both types of cervical carcinoma is dependent on the infection of oncogenic types of HPV. HPV infection could be diagnosed on the basis of whether or not the DNA virus in present. In pregnant women the latent-persistent infection easily changes into its active form. This process is related to changes in immunological response and concentration of the hormones. Aim: The main aim of the study was to evaluate the frequency of HPV infection in healthy pregnant women in second and third trimester of pregnancy and the presence of selected risk factors. Material and methods: The study was conducted in 2005-2006 on hospitalized women in The Clinic of High Risk Pregnancy. The first group consisted of 180 pregnant women in 2nd trimester of pregnancy, the second comprised220 pregnant women in the 3rd trimester. In all women the Pap-smears and diagnosis of DNA presence of high and low risk HPV from the border line of cervical epithelium were tested on the first day of the hospitalization. The PCRmethod using Human Papilloma Virus Typing Set was used. Results: In 400 pregnant women the presence of HPV was found in 4,5%, type 16 was fund in 2,5%, type 18 in 1,7%. Combined infection 16 and 18 types was found in 0,2%. In 180 pregnant women in II trimester high risk HPV was found in 4,4%: 16 type was found in 2,8%, 18 type in 1,7%. In III trimester high risk HPV was found in 4,5%: 16 type was found in 2,3%, type 18 in 1,8%, combined 16 and 18 in 0,4%. Low risk HPV was found in 1,0%- type 6. In II trimester in 1,1%, In III trimester 0,9%. There were no differences between HPV infection rate in II and III trimester, pregnant women age, the gravity andHSV2 infection. The difference was found between high risk HPV infection and parity, cigarette smoking and oncological family history. Conclusion: Asymptomatic HPV infection has the same frequency in II and III trimester. High parity, cigarette smoking and oncological family history were connected with an increased rate of high risk HPV infection. All women in reproductive age should be checked for the HPV DNA

Evaluation of tissue metalloproteinase inhibitor TIMP-1 and Survivin levels during third trimester pregnancy — a preliminary report

Objectives: A proper implantation of trophoblastic cells and an appropriate metalloproteinases activity is required to cause disintegration of basal membranes of cells. The activity of tissue matrix metaloproteinases can be inhibited by their matrix inhibitors — TIMP-s. Survivin is a member of inhibitor of apoptosis proteins family (IAP), that suppresses caspase activation, influences VEGF expression and promotes proliferative action of endothelial cells. Material and methods: The aim of the study was to assess concentrations of two independent anti-apoptotic factors. TIMP-1 and survivin in serum of women in their third trimester of pregnancy and in umbilical cord blood of neonates – drawn separately from veins and arteries. The study group consisted of 29 pregnant women in physiological pregnancy and with correct fetal development, in gestational age between 37 to 40 weeks of gestation. Blood used in the study was collected from maternal cubital fossa veins and from neonatal umbilical cords (from veins and from arteries separately). The research was conducted using TIMP-1 and Survivin ELISA kits from R & D Systems according to manufacturers’ recommendations and protocols. Results: The concentrations of TIMP-1 were similar and independent of the source of blood samples. Arterial values of TIMP-1 in umbilical cord compared to maternal and fetal veins were slightly lower, but no statistical difference was found. The mean concentrations of Survivin were comparable but we found that in some cases the results in cord blood serum in both vessels-vein and arteries were almost negative. Arterial values of Survivin in umbilical cord compared to maternal blood were higher, but no statistical difference was found. Conclusions: In III-rd trimester of pregnancy parameters of Timp-1 and Survivin — anti-apoptotic substances concentration were similar in maternal and cord blood in both artery and vein. We found no increased activity of selected antiapoptotic factors

Analiza porównawcza wybranych parametrów angiogenezy naczyniowej w łożyskach pochodzących z ciąż bliźniaczych dwuzygotycznych

Introduction: Most of preIntroduction: Most pregnancies after assisted reproduction techniques are dizygotic twin gestations. There is a close relationship between the development and functioning of the placenta and the growth of both fetuses in dizygotic twin pregnancies. Angiogenesis is the process of creating new capillaries. Objectives: The aim of the study was to compare the expression of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOs) between placentas of dizygotic twins, taking into account their birth weight. Materials and Methods: The study included 35 women in dizygotic twin pregnancies, resolved after 30 completed weeks of gestation by a caesarean section. The patients were divided into two groups: twins whose weight did not differ by more than 20% (group 1) and twins whose weight differed by more than 20% (group 2). Twins with higher and lower birth weight were classified as A and B, respectively. A comparative analysis of the placentas of twins A and B with regard to the selected parameters of angiogenesis, i.e. VEGF and eNOs, was performed. Results: A strong expression of VEGF was observed in twins with lower birth weight in group 1, as well as a strong expression of eNOs in twins with higher weight in group 2, and with lower weight in group 1. Conclusions: Neovascularization is more expressed in the placentas of twins with lower birth weight (in the group with no significant differences in weight), possibly reflecting the existence of efficient mechanisms of compensation. High expression of e-NOS may indicate an increased risk of ischemia with intact endothelium.Wstęp. Większość przypadków ciąż pochodzących z technik wspomaganego rozrodu to ciąże bliźniacze dwuzygotyczne. Obserwuje się ścisłą zależność między rozwojem i funkcjonowaniem łożyska a wzrastaniem obu płodów. Angiogeneza to proces tworzenia nowych naczyń włosowatych. Cel pracy. Porównanie wartości ekspresji czynnika wzrostu śródbłonka naczyniowego – VEGF oraz endotelialnej syntazy tlenku azotu – eNOs między łożyskami bliźniąt dwuzygotycznych z uwzględnieniem ich masy urodzeniowej. Materiał i metody. Do badania zakwalifikowano 35 kobiet w ciąży bliźniaczej dwuzygotycznej po ukończonym 30 tygodniu ciąży rozwiązanych drogą cięcia cesarskiego. Grupa została podzielona na dwie części: bliźnięta, których masa nie różniła się o ponad 20% (grupa 1) i bliźnięta, których masa różniła się o ponad 20% (grupa 2). Bliźnię o wyższej masie urodzeniowej zakwalifikowane zostało jako A, natomiast bliźnię o niższej masie urodzeniowej jako B. Dokonana została analiza porównawcza łożysk bliźniąt A i B pod względem wybranych parametrów angiogenezy – VEGF i eNOs. Wyniki. Stwierdzono silną ekspresję VEGF w grupie 1 u bliźnięcia B oraz silną ekspresję eNOs w grupie 2 u bliźniąt A i w grupie 1 u bliźniąt B. Wnioski. Neowaskularyzacja jest bardziej nasilona w łożyskach bliźniąt o niższej masie urodzeniowej, gdzie nie obserwowano istotnej różnicy mas, co być może jest wyrazem istnienia sprawnych mechanizmów kompensacyjnych. Wysoka ekspresja e-NOs może oznaczać zwiększone ryzyko niedotlenienia przy jednocześnie nieuszkodzonym śródbłonku

Influence of pharmacological treatment on selected parameters of intrahepatic cholestasis of pregnancy

Summary Intrahepatic cholestasis occurs most frequently in the third trimester of pregnancy. It is characterized by elevated concentrations of liver enzymes and bile acids. The main aim of the study was to analyze the changes of concentration in biochemical indicators of cholestasis during the treatment. Material and methods: The study was conducted in the group of 38 women with diagnosed intrahepatic cholestasis in pregnancy and hospitalized in Medical University Lodz, High Risk Pregnancy Clinic in 2007-2008. Treatment constituted UDCA in 750mg per 24h and Essentiale Forte 3 times a day. The concentrations in serum of AspAt, AlAt, ALP, GGTP, bile acids and bilirubin were estimated before and after 7 and 15 days of the treatment. Results: Mean concentration of AlAt was 262±16.26 U/L, AspAt 146±141.17 U/L, ALP 189±60.64 U/L, bile acids 28.6±15μmol/L, GGTP 31.5±28.15U/L but only in 28,9%was elevated. After 7 days the decrease of mean concentrations of AlAt (165±126.7 U/L) and AspAt (85±59.62 U/L) was observed. The concentration of ALP was similar to the previous results (190±71.94 U/L). After 15 days mean values of AlAt and AspAt decreased to 119±103.56 U/L and 65±46.12 U/L (

Ocena przydatności stężenia rozpuszczalnej endogliny jako czynnika predykcyjnego wystąpienia stanu przedrzucawkowego u ciężarnych z nadciśnieniem tętniczym

Introduction: Preeclampsia is a pregnancy-specific syndrome that occurs after the 20 weeks of pregnancy, and is characterized by hypertension and proteinuria. It complicates approximately 5-6% of all pregnancies and is a major factor in fetal and neonatal mortality. Objectives: The aim of this study was to evaluate serum concentration of soluble endoglin (sEng) as the predictorn of preeclampsia in pregnant women with hypertension. Material and methods: The study was conducted at the Department of Pathology of Pregnancy (Department of Gynecology and Obstetrics, Medical University of Lodz), and the clinical ambulatory of the WSSz – M. Madurowicz (at present, WSSz – M. Pirogow) in Lodz, between 2008-2012. The Committee of Bioethics, Medical University of Lodz approved of the research (RNN/106/08/KE, May 20, 2008). The study included 86 pregnant women, between 25 and 40 weeks of pregnancy. The subjects were divided into 3 groups: – Group HA – 33 pregnant women with hypertension arterialis (≥140/90 mmHg) without proteinuria, – Group P – 21 pregnant women with hypertension arterialis (≥140/90 mmHg) with proteinuria, – Group K – 32 pregnant women with normal blood pressure (Wstęp: Stan przedrzucawkowy to swoisty dla ciąży zespół występujący po 20 tygodniu ciąży, charakteryzujący się nadciśnieniem tętniczym i białkomoczem. Komplikuje 5-6% ciąż i jest jednym z głównych czynników umieralności płodów i noworodków. Cel pracy: Celem pracy była ocena stężenia rozpuszczalnej endogliny (sEng) w surowicy krwi jako czynnika predykcyjnego wystąpienia stanu przedrzucawkowego u ciężarnych z nadciśnieniem tętniczym. Materiał i metody: Badania zostały przeprowadzone w Klinice Patologii Ciąży I Katedry Ginekologii i Położnictwa Uniwersytetu Medycznego w Łodzi oraz w Przychodni Przyszpitalnej WSSz. im. M. Madurowicza a obecnie im. M.Pirogowa w Łodzi w latach 2008-2012. Na przeprowadzenie badań uzyskano pozytywną opinię Komisji Bioetyki Uniwersytetu Medycznego w Łodzi numer RNN/106/08/KE z dn. 20.05.2008 r. Do badania włączono 86 ciężarnych, między 25 a 40 tygodniem ciąży, które podzielono na 3 grupy: – Grupa HA – 33 ciężarne z nadciśnieniem tętniczym (≥140/90 mmHg) bez białkomoczu. – Grupa P – 21 ciężarnych z nadciśnieniem tętniczym (≥140/90 mmHg) i białkomoczem. – Grupa K – 32 ciężarne z prawidłowymi wartościami ciśnienia tętniczego

Evaluation of soluble concentration Fas and Fas ligand in maternal and cord blood 3rd trimester of pregnancy

Objectives: The the study was to estimate the concentrations of antiapoptotic sFas and pro-apoptotic FasL in the serum of pregnant women in the third trimester of pregnancy and in the cord blood serum of neonates from vein and arteries separately. The correlation could be crucial for evaluation of apoptosis process intensity in placenta and the role of fetal blood circulation system on distribution of sFas and FasL. Material and methods: The study group consisted of 28 pregnant women in physiological pregnancy, between 38– 41 weeks. Vein blood was taken from maternal elbow vein and umbilical cord, separately from vein and arteries. The research was done by sets for sFas and FasL from R&D Systems Elisa kit. Results: In arterial and vein cord blood there were much more lower concentrations of sFas than in maternal blood-arterial cord blood 3351.78 pg/mL, vein cord blood 3351.78 pg/mL versus maternal blood 5769.62 pg/mL (p < 0.001). No differ­ence was found in sFas concentrations between cord arterial and vein blood sera. Statistical difference was found between mean concentration of Fas ligand in maternal blood serum (71.36 pg/mL) and arterial cord blood serum (164.57 pg/mL) p < 0.05 (p = 0.001). Cord arterial blood serum showed much higher concentrations of FasL than maternal blood serum. No difference was found between cord arterial and vein blood sera concentrations of FasL: 164.57 pg/mL vs. 170.00 pg/mL (p = 0.701). Conclusions: Obtained results suggest no influence of sFas and FasL production on fetal organism apoptosis. Lowering of sFas concentration in fetal blood could mean the increase of apoptosis in fetal organism compared to maternal. Higher concentration of FasL in cord blood than in mothers suggests higher apoptosis intensification in fetal circulation and no influence of blood flow across placenta on its concentration